NGC requires more detailed information to verify that the guideline is based on a systematic review of the evidence and that there was an assessment of the benefits and harms of the recommended care and alternative care options. See Revised Inclusion Criteria 3 and 4 for a description. Documents required to meet inclusion include:

All new/updated guidelines submitted to NGC must be based on a recent systematic review. Currency will be established by review of the following: a description of the search strategy that includes a listing of database(s) searched, a summary of search terms used, the specific time period covered by the literature search including the beginning date (month/year) and end date (month/year), and the date(s) when the literature search was performed. In addition, the guideline's bibliography will be assessed for consistency with the date ranges of the literature searches.

NGC staff will follow up with guideline developers on an individual basis for any missing documentation. In situations where the documentation may not sufficiently meet the inclusion requirements, the submission will be reviewed by NGC senior staff, members of the Editorial Board, and by AHRQ for a final determination.

Guidelines submitted and accepted for inclusion under the 1997 criteria will remain on the NGC site until they are revised by the developer, withdrawn by the developer, or withdrawn by NGC because they are no longer considered current (i.e., when they are ≥5 years old). As a result, there could be guidelines on NGC that were accepted under the 1997 criteria through 2019. However, it should be noted that guidelines included under the 1997 criteria could also meet the standards of the 2013 (revised) criteria.

You can use the "Guidelines Meeting NGC's 2013 (revised) Inclusion Criteria" filter on the Advanced Search page to see which guidelines meet the revised criteria. Guidelines that meet the 2013 (revised) inclusion criteria also have a note in the "Guideline Status" field.

NGC's 2013 (revised) inclusion criteria reflect the 2011 Institute of Medicine (IOM) definition of a clinical practice guideline. The definition emphasizes two important aspects of a guideline that should be represented in good evidence-based guidelines: being based on a systematic review and assessing the benefits and harms of recommended care and alternative care options. These revised inclusion criteria ensure that guidelines in NGC will meet this new minimum standard.

The Inclusion Criteria were revised to keep them current with advances in the field. In March 2011 the Institute of Medicine (IOM) published Clinical Practice Guidelines We Can Trust* which redefined clinical practice guidelines (CPGs) as "statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options." The 2013 (revised) inclusion criteria bring NGC into alignment with the new definition of guidelines.

The revised inclusion criteria represent several years of effort that included expert knowledge, the input of guideline developers and implementers, and assessment of over 100 guidelines represented in NGC.

My NGC Personalization

My Recent Searches: Terms you have recently searched appear on the home page directly below the main search box. Your three most recent searches are displayed ("View all…" will display up to 10 recent searches); clicking the term will run the search and display up-to-date results for that term (no account creation required).

My Recently Viewed Guideline Summaries: Guideline summaries you have recently viewed appear on the home page. Your five most recently viewed summaries are displayed; clicking a title will display the summary page (no account creation required).

My Favorite Guideline Summaries: When viewing an individual guideline summary, you can save it as a "favorite." There is no limit to the number of summaries you can save to favorites. You will have the option to receive weekly e-mail alerts when your favorite summary or summaries have been updated or withdrawn from the site.

How to save a summary as a favorite: Navigate to an individual guideline summary and click the "Save to Favorites" button at the top right corner of the summary (account creation required). A pop-up window will appear allowing you to save the summary as a "favorite."

My Favorite Organizations: You can save an organization as a "favorite." There is no limit to the number of organizations you can save to favorites. You will have the option to receive weekly e-mail alerts when a new summary or summaries associated with that organization have been published or if one or more summaries associated with that organization have been updated or withdrawn from the site.

How to save an organization as a favorite: In the By Organization browse, clicking on the star next to the organization's name will cause a pop-up window to appear allowing you to save the organization as a "favorite." Similarly, if you browse directly to an organization, you can save it as a "favorite" by clicking "Save to Favorites" in the top right corner of the organization results page (account creation required).

Topic Alerts: You can sign up for e-mail alerts on topics of interest. The NGC topics have been chosen based on resources such as Healthy People 2020 and relevant content in the NGC database. An alert will be sent when a summary or summaries, associated with that topic, have been published, updated, or withdrawn.

Expert Commentary Alerts: You can sign up to receive an alert when a new expert commentary is published to the NGC site.

My E-mail Alerts: Defined by favorite content, you can receive weekly e-mail alerts when your favorite content is published, updated, or withdrawn (account creation required). Refer to "What types of custom e-mail alerts are available and how can I sign up?" below for further information.

You can create an account directly from the home page, by clicking the My NGC button in the left navigation, or by clicking the Sign in link in the top right corner of the site. To create an account, enter an e-mail address (required), password (required), password confirmation (required), first name (optional), and last name (optional).

Every Monday, you will receive of digest of personalized content. Note: You will not receive an e-mail unless there are changes to your favorite content.

Alerts are available on any or all of the following:

How to sign up for Favorite Guideline/Measure Summary Alerts: Favorite summary alerts are accessible from your My NGC Dashboard (account creation required). You may also sign-up to receive favorite summary alerts when you save a summary to your favorites via the pop-up window. An alert will be sent when your favorite summary or summaries have been updated or withdrawn from the site.

How to sign up for Favorite Organization Alerts: Favorite organization alerts are accessible from your My NGC Dashboard (account creation required). You may also sign-up to receive Favorite Organization alerts when you save an organization to your favorites via the pop-up window. An alert will be sent when a new summary or summaries associated with that organization have been published or if one or more summaries associated with that organization have been updated or withdrawn.

How to sign up for Topic Alerts: Topic alerts are accessible from your My NGC Dashboard (account creation required). By clicking "Add Topic Alerts" a pop-up window will appear with a list of available topics. A "Create Topic E-Mail Alerts" button is also accessible from the By Topic browse. An alert will be sent when a summary or summaries, associated with a topic, have been published, updated, or withdrawn.

How to sign up for Expert Commentary Alerts: Expert Commentary alerts are accessible from your My NGC Dashboard (account creation required). A "Create Expert Commentary E-Mail Alerts" button is also accessible from the Expert Commentaries landing page. An alert will be sent when a new Expert Commentary is published to the site.

E-mail alerts are issued weekly on Monday. Note: You will not receive a My NGC e-mail alert unless there are changes to your favorite content. Personal alerts will not affect the NGC/NQMC weekly e-mail (you will continue to receive this e-mail separately every Monday if you have subscribed).

In order to remove recent searches and recently viewed summaries, you must clear your cache in your Web browser. In Internet Explorer 9, click on Tools, then Internet Options, and then click on the General tab. Under Browsing History, click Delete. Note: Make sure "preserve favorites website data" is NOT selected.

In order to prevent recent searches and recently viewed summaries from being tracked, you must disable cookies in your Web browser. In Internet Explorer 9, click on Tools, then Internet Options, and then click on the Privacy tab. Next, click on the Advanced button and select the "Override automatic cookie handling" option. Next, block first-party cookies, and click OK. Clear your internet browser cache, close all open browsers, and return to the NGC home page.

Guideline Summaries

NGC uses a systematic approach to decide when it is appropriate to include author, year citations in the Major Recommendations field and full citations in the References Supporting the Recommendations field. Two criteria drive the decision-making process: (1) the recommendations are explicitly stated, and (2) those explicit statements are referenced. The first criterion means that the recommendations in the guideline document are easily identified, stand-alone, action-oriented statements. Explicit recommendation statements are not interspersed among rationale in the guideline document. Rationale for the recommendations may be provided in sections before or after the actual recommendations but not within the same body of content as the recommendations. The second criterion means that the reference(s) supporting the explicit recommendation is (are) provided at the end of the statement. References cited in the rationale for the recommendation are not captured.

The U.S. National Library of Medicine (NLM) has developed the Unified Medical Language System (UMLS) to "facilitate the development of computer systems that behave as if they "understand" the meaning of the language of biomedicine and health. The UMLS consists of three knowledge sources, the Metathesaurus, the Semantic Network, and the Specialist Lexicon, as well as computer tools to help developers integrate the information from these sources.

The Metathesaurus is a collection of more than 100 controlled vocabularies, thesauri, and code sets linked together via high-level semantic concepts. NGC's master's level indexers apply terms from selected UMLS vocabularies to each guideline summary, expert commentary, and guideline synthesis to facilitate searching and browsing and to create relationships between similar documents. These vocabularies are:

There are no copyright restrictions that prevent users from copying and/or distributing content found on NGC, provided that all content is appropriately identified. NGC's content (i.e., guideline summaries, guideline syntheses, and expert commentaries) is available for public use, and we encourage the distribution of our content, particularly for educational purposes. NGC content may not be used for commercial and/or product endorsement purposes.

Although most of NGC's content is free of restrictions, exceptions occur where individual guideline developers have requested otherwise. Refer to the Copyright Statement field at the end of each summary to determine if whether such restrictions apply and if users need to contact the guideline developer.

NGC seeks and receives permission from guideline developers to include summaries of the original full-text guidelines that appear at www.guideline.gov. NGC does not have the authority to grant copyright clearance for the original full-text guidelines upon which the summaries are based. If you are interested in using/distributing the original full-text guideline, you must contact the guideline developer.

Users can go to the Guidelines in Progress browse to see a list of guidelines in the work queue. Guidelines on this page include new and updated content that meet Inclusion Criteria and have the necessary copyright permissions.

NGC summaries reflect the most recent version of a guideline. NGC does not retain summaries of earlier versions of guidelines that have been updated or withdrawn by the developer. Contact the guideline developer directly for information regarding earlier versionsof a particular guideline.

See the Guideline Archive for more information. This feature provides a complete list of summaries that have been withdrawn from the NGC Web site. Information regarding a current NGC summary, where available, is provided. The listings are organized alphabetically by guideline developer.

As part of the NGC Annual Verification, many guidelines are withdrawn from the Web site at the end of every year because they no longer meet our Inclusion Criteria with respect to date. NGC's inclusion criteria specifically require that guidelines represented in our database have been developed, reviewed, or revised within the last five years. All guidelines that no longer meet this criterion are removed from the Web site at the end of each calendar year. See the Guideline Archive for a list of withdrawn or updated summaries.

To learn whether a guideline update is in progress, contact the guideline developer directly.

Searching/Browsing

You can type your search term in the search box accessible in the masthead of all NGC Web pages to quickly search the database. You can also browse the NGC database by Topic (Disease/Condition, Treatment/Intervention, Health Services Administration) or Organization.

The About Search page contains useful tips on how to search the NGC database for guidelines of interest. You can also use Advanced Search to perform refined searches of the NGC database. This feature allows you to filter your search by one or more guideline attributes (e.g., Clinical Specialty, Intended Users, Guideline Category).

No. The main search engine searches the contents of the guideline summary as well as its metadata (i.e., UMLS concepts). In Advanced Search, NGC searches the specific field(s) in the database corresponding to the criteria you select. For more information on searching guidelines, see About Search.

Your search may not yield content matching the criteria you specified. This can happen for several reasons:

You may have misspelled a word (see suggested terms provided).

Your search may be too specific. If you are using the search box, try using more general terms. If you are using the Advanced Search, select fewer options.

NGC may not yet have the guideline you are seeking. Content is constantly changing, with new guidelines added frequently. Bookmark this site and make sure to check back often. To be notified by e-mail on a weekly basis when new and updated content is added to the site, see the Subscribe to Weekly E-mailpage.

Technically, NGC offers three ways to find guidelines: Browse, Search, and Advanced Search. The "Find" heading on the home page directs users to the various "browse" features on the Web site that can be found in the left-hand navigation menu under the "Guidelines" button. These browses include: Browse by Topic, Browse by Organization, Browse Guidelines in Progress, Browse Guideline Index, Browse Guideline Archives, Browse Related NQMC Measures.

"Search," also known as "basic search" or "main search" is accessed via the search box on the home page or globally in the masthead. The NGC search engine operates by seeking matches with search terms from two distinct types of data pulled from the contents of NGC: layer of semantic metadata associated with a content piece, and the exact matches of words or phrases in the text. See About Search for additional information.

The "Advanced Search" leverages the power of the main/basic search engine while also allowing the user to select specific subsets of guideline summaries. The total data set is narrowed as the user selects filters to refine their search results. See About Search for additional information.

The Guideline Matrix is a tool used to retrieve and export relevant content of interest. Select a field (a row and a column) to filter NGC summary content by selected attributes. The site will generate a table of all guidelines at the intersection of those two fields. Click on the count within each cell to access your result set. Table and result set are downloadable into Excel.

Each guideline summary provides a printable view via the Print link and several download types: PDF (download the free Adobe Reader), Word (compatible with Word 1997 and higher), HTML, and XML. A citation for individual guideline summaries can also be downloaded into EndNote by clicking on the Citation Manager link.

Miscellaneous

Guidelines produced by AHRQ are no longer included in NGC because these documents are more than five years old. AHRQ also considers these guidelines, either in whole or in part, out of date. For more information, see the AHRQ Web site. Users can also see the Guideline Archive.

Evidence-based clinical guidance documents are heterogeneous, as is the terminology utilized to describe and/or label them. The phrases "guideline," "protocol," "practice parameter," "pathway," "standard," etc., are used in many different contexts by different guideline developers. Any document meeting NGC's Inclusion Criteria is eligible for inclusion, regardless of how it is labeled.

For guidelines for which NGC has received the necessary permissions from the guideline developer, links are provided from the NGC summary to the full-text document at the developer's Web site. Users can find this link by referring to the "Related Content" tab at the top of each summary or by going to the Guideline Availability field that appears near the end of each summary. NGC is unable to fulfill orders for printed copies of the original full-text document.

Currently NGC offers the My NGC Tutorial on how to use the personalization features and the Search Tutorial on how to use the search and browse features. NGC plans to develop more tutorials that will instruct users on other aspects of the Web site.

NGC does not have medical professionals or physicians on staff to answer patients' questions and/or to advise on health-related issues or experiences. If you think you may have a medical emergency, call your doctor or 911 immediately.

If you are citing the original guideline upon which the summary or synthesis is based, please refer to the Source field included in each guideline summary or the sources listed under the Guidelines Being Compared section found at the top of each guideline synthesis.